What is a Leaky Gut, and How Do You Know If You Have One?
If I’m being honest, I really wish they called it something else. “Leaky gut” just sounds so gross… and the condition itself is unpleasant enough!
(December 13, 2021: This post was medically reviewed by Dr. Omar Akhter, MD.)
My journey with healing from leaky gut
I was actually mortified when I first started connecting my digestive and autoimmune symptoms to “leaky gut” back in 2009. At that time, most health practitioners weren’t acknowledging leaky gut to be anything more than a theory.
That said, as a new clinician at the time, I chose to keep any and all leaky gut investigations and findings to myself for many years out of fear of being judged/criticized by my colleagues and co-workers. I kept my mouth shut so I would fit in and be respected.
Although I had taken all the mainstream advice and went through the motions with invasive endoscopes, Lactaid pills, Prilosec, Zantac, Tums, Gas-Ex, probiotics (which were somewhat helpful) and even restrictive elimination diets (out of desperation), I knew deep down I was going to eventually need to address leaky gut head-on, from a holistic standpoint. With all do respect, that stuff was just not cutting it and I was getting worse.
Thank goodness after un-turning lots of rocks and stones over the years, I was eventually able to find enough holistic-minded practitioners and like-minded peers who knew a lot about leaky gut, validated everything I was going through, and helped support me down the path to recovery!
Fast-forward to now (2021): I’m no longer suffering from an esophageal web, eosinophilic esophagitis, IBS, lactose intolerance or leaky gut. I have 12 less food and environmental histamine-mediated allergies than I did in 2013-2014 based on skin testing and blood work before-and-after. I get to eat a lot more foods than I used to without reacting in my throat or stomach.
- Disclaimer: Although my diet is much more flexible now than it was, I’m still extremely conscious and mindful of how I live and what I put in my body. I don’t eat what most would consider “normal” and I don’t follow a Standard American Diet because that didn’t and still doesn’t work for me. But I feel younger, more vibrant and more energized now than I did 10 years ago so it’s a huge return on investment!
I count my lucky stars and realize now all of that happened FOR me, not TO me. I love the person I’ve become in spite of going through all that and finding my way out of it through a path less traveled.
What IS leaky gut?
Although we’re all supposed to have a semi-permeable gut lining which allows us to absorb nutrients from food, our gut lining is also meant to serve as a barrier between our internal body (blood and internal organs) and the outside world.
“Leaky gut” is NOT a medical diagnosis! It’s a term used to describe a damaged gut lining. This occurs when the cells that collectively make up the gut lining weaken, causing the “tight junctions” between the cells to open up, thus creating more space for unwanted substances or particles that don’t belong in the body to “leak” into the blood (1, 2).
- A few common examples of unwanted substances “leaking” into the body through the gut could be pesticide residues from food, pathogenic microbes (such as candida overgrowth which is very common), poorly digested food particles, metals or plastics from food containers, antibiotics from livestock products, etc.
It’s also important to note: when something is inside our gut, it isn’t yet inside the body! It’s kind of like the hole in the middle of a donut not being part of the donut. (As a quick FYI, the gut starts in the mouth and esophagus and goes all the way down into the stomach, intestines, colon and rectum. Each of us adults has enough gut tissue to cover a tennis court!)
Signs and symptoms of leaky gut
Leaky gut can manifest with or without digestive ailments.
Unwanted substances and particles entering the bloodstream through a damaged gut lining will begin to reek havoc over time if left un-checked, and will show up differently for everyone.
Some of the most common symptoms of leaky gut include a combination or spectrum of any of the following: fatigue/brain fog, multiple nutritional deficiencies, multiple food/environmental allergies, sensitivities, hormonal imbalance (such as PCOS or diabetes), autoimmune conditions, thyroid abnormalities, acne, asthma, and/or even a broad range of psychiatric conditions such as depression/anxiety/ADHD/autism, Alzheimer’s, and more (1, 2, 3, 4, 5, 6).
What causes leaky gut?
We require healthy bacteria to support a healthy mucosal membrane in the gut, so usually leaky gut will typically go hand-in-hand with dysbiosis (an imbalance of beneficial/healthy flora vs pathogenic bacteria/fungus in our gut) (2).
Although leaky gut can be considered an underlying root cause in many health conditions, leaky gut is usually ALSO a symptom or side-effect (much like a domino chain of events) from one or more other underlying conditions such as:
- Celiac disease/non-celiac gluten sensitivity, candida overgrowth, small intestinal bacterial overgrowth (SIBO), foodborne illness/infections in the gut, food sensitivities (a chicken-or-the-egg situation), stress/trauma, alcohol/drug abuse, an eating disorder, or a laundry list of medications which either disrupt the gut flora/ “microbiome” or cause direct damage to the gut lining itself (that’s a conversation for another time!).
- Leaky gut is also associated with nutritional deficiencies such as vitamin A, vitamin D, and zinc (5); however we can’t always determine which came first. Leaky gut and nutritional deficiencies also seem to exacerbate each other, making both worse off.
Can you test for leaky gut?
Yes! The most popular test available for testing leaky gut would be an Intestinal Permeability Assessment by Genova Diagnostics (which measures the absorption of lactulose and mannitol in the gut over a period of time). However, these particles are not considered very large and so it can be difficult to assess what degree of damage there is for people with larger space between their tight junctions. This test is also expensive and not pleasant to do (some might say a poor “user experience).
A few other testing options to measure gut permeability include a serum zonulin blood test (high zonulin indicates/implies there may be damage to the gut) and zonulin antibody tests which may be more accurate, since zonulin is more of a snapshot in time and it doesn’t stay in the blood for long after it has been released by the gut (7).
Most people choose not to test for leaky gut and instead address underlying implications (such as a root-cause approach, paired with diet/lifestyle and stress management). There are many other types of tests which can be more constructive beyond confirming whether or not a person has leaky gut! (This is going to vary from person to person depending on many factors such as your individual health condition).
- My preferred tests would be any and all diagnostic testing to rule out underlying conditions (to be done through working with a GI doctor), as well as GI mapping to address dysbiosis, and mediator release testing to address food sensitivities (to be done with a certified LEAP dietitian!). Fun fact: I’m currently in training to become a LEAP dietitian (hopefully certified within the next few weeks) and I look forward to integrating mediator release testing into my practice! Stay tuned. 🙂
Can you heal if you have a leaky gut?
Absolutely! I’ve been able to heal myself and reverse the majority of my health issues that stemmed from leaky gut first-hand through a combination of diet, lifestyle, herbs and energy medicine. I have also since helped hundreds of others in my private practice to restore their gut health and balance their hormones/immune system primarily with a “food as medicine” approach.
It’s not easy, there’s no “quick fix” and healing of any kind does not happen over night but it can be done.
How long does it take to heal your gut?
Based on first-hand experience and observation, I believe healing a leaky gut can take anywhere from 6 months to 2-10 years to heal from and resolve leaky gut health issues. It will depend on where you’re at from a clinical standpoint when you start addressing it, your genetics, how old you are, what caused your leaky gut, how long you’ve had it, what else is going on with your health/lifestyle/diet/stress, and how consistent you can remain once you’ve “cracked the code”. 😉
Keep in mind: there is no “One Size Fits All” approach when it comes to healing your leaky gut! If you’re on that journey, I encourage you to grab my free gut health nutrition guide so you don’t make the same 5 diet mistakes so many people out there are making.
I foresee more and more people will be learning how to address their health at this level in the coming years as we transition into the new paradigm.
All of that said, I’m in the process of creating and launching a six-part program on how to heal and seal your leaky gut so if you’re interested in joining me later this year, hop on the waiting list below, and I’ll keep you posted!
Thanks for reading, and I hope this helps you along your journey!!!
Lots of love,
- Camilleri, Michael. “Leaky gut: mechanisms, measurement and clinical implications in humans.” Gut 68,8 (2019): 1516-1526. doi:10.1136/gutjnl-2019-318427
- König, Julia et al. “Human Intestinal Barrier Function in Health and Disease.” Clinical and translational gastroenterology vol. 7,10 e196. 20 Oct. 2016, doi:10.1038/ctg.2016.54
- Fasano, Alessio. “All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases.” F1000Research vol. 9 F1000 Faculty Rev-69. 31 Jan. 2020, doi:10.12688/f1000research.20510.1
- Obrenovich, Mark E M. “Leaky Gut, Leaky Brain?.” Microorganisms 6,4 107. 18 Oct. 2018, doi:10.3390/microorganisms6040107
- Bischoff, Stephan C et al. “Intestinal permeability–a new target for disease prevention and therapy.” BMC gastroenterology 14 189. 18 Nov. 2014, doi:10.1186/s12876-014-0189-7
- Paray BA, Albeshr MF, Jan AT, Rather IA. Leaky Gut and Autoimmunity: An Intricate Balance in Individuals Health and the Diseased State. International Journal of Molecular Sciences. 2020; 21(24):9770. https://doi.org/10.3390/ijms21249770
- Vojdani, Aristo et al. “Fluctuation of zonulin levels in blood vsstability of antibodies.” World journal of gastroenterology 23,31 (2017): 5669-5679. doi:10.3748/wjg.v23.i31.5669